Kornimate/medical-research-clean huggingface dataset:
prevalence of major vessels underlying the potential incision site for emergency front of neck airway access in adult surgical patients with impalpable neck anatomy

Conditions: Airway Complication of Anesthesia

Summary: patients undergoing general anesthesia require assistance with their breathing and with the delivery of oxygen to their lungs. to achieve this, an anesthesiologist inserts a type of plastic breathing tube into the airway via the mouth called an endotracheal tube or laryngeal mask airway. in rare circumstances, the anesthesiologist may not be able to adequately provide oxygen via these methods. in this life-threatening situation, an anesthesiologist may be forced to make an incision in the front of the neck to access the trachea (windpipe) so that emergency oxygen can be provided. this life-saving technique is known as emergency front-of-neck access (efona) and is used to prevent low oxygen levels which cause irreversible brain damage and/or death. this rarely performed procedure carries a risk of harm from bleeding, injury to the airway or inability to access the trachea to provide oxygen. emergency front of neck access is more likely to be required in patients with abnormal airway anatomy, for example, in patients with obesity and large neck circumference, neck cancer, or a history of head and neck radiation therapy. though the optimal technique for efona is not clear, prominent guidelines advise the use of an 8-10cm incision upwards from the top of the breastbone in order to identify airway structures which cannot be easily felt by the anesthesiologist from the front of the intact neck. this differs from patients who have airway structures which may be easily located at the front of the neck, whereby a smaller incision may be made or a needle inserted into the trachea (widepipe) to provide oxygen. the neck contains major blood vessels which lie close to the airway and these blood vessels may be injured during the 8-10cm incision, creating further difficulty accessing the airway to provide life-saving oxygen. this study aims to assess for the presence and size of major blood vessels which may be damaged by this incision by using non-invasive ultrasound which will be placed on the skin of your neck to assess for such blood vessels prior to you undergoing anesthesia. our study aims to assess the normal anatomy in the adult population such as yourself to understand what to expect when managing patients who require this life-saving therapy.


Eligibility criteria:
inclusion criteria: * healthy volunteers * ability to understand the rationale of the study assessments and to provide signed consent * ability to safely and comfortably take part in the study protocol exclusion criteria: * participant refusal * participant less than 18 years old or older than 80 years old * participants who do not speak english or cannot give informed written consent without assistance

Keywords: font of neck access blood vessels ultrasound
trigger protocol on the rate of pregnancy after intracytoplasmic sperm injection

Conditions: Infertility

Summary: infertility is a condition affecting both female and male, characterized by the inability to conceive after 12 months or more of regular, unprotected sexual activity. all over the world, over 186 million people are affected by this condition, with the majority living in developing countries. in developing countries, the prevalence of infertility among women of reproductive age is estimated to affect one in every four couples. type of the trigger during intracytoplasmic sperm injection might has impact on pregnancy rate.

when 3rd generation gonadotropin-releasing hormone antagonists (gnrh-a) were introduced in the 1990s for ovarian induction protocols, it became possible to trigger final oocyte maturation and ovulation with a single bolus of gnrh-a as an alternative to human chorionic gonadotropin (hcg). although some studies have suggested an increase in the percentage of mature 2 ((mii) oocytes retrieved with gnrh-a compared to hcg, it has been found that triggering ovulation with only gnrh agonist leads to a suboptimal luteal phase. the term "dual trigger" was first defined as the combination of a gnrh agonist and a low dose of hcg for triggering terminal oocyte maturation and avoid ovarian hyperstimulation syndrome (ohss) in gnrh antagonist protocols. lin et al, conducted a retrospective study represent normal responders undergoing intracytoplasmic sperm injection )icsi (with a gnrh antagonist trigger. they demonstratedsignificant improvements in the total number of retrieved oocytes, the number of mature (mii) oocytes, and rates of embryo implantation, clinical pregnancy, ongoing pregnancy, and live birth rate when the dual trigger protocol was used. similarly, lu et al. presented a retrospective analysis of fertility centers records where final oocyte maturation was triggered by either gnrh alone (decapeptyl 0.1-0.2 mg) or in combination with hcg (1,000, 2,000, or 5,000 iu). they concluded that employing a dual trigger with a low dose of hcg (1,000 iu) as an adjunct to gnrh-a significantly improved the oocyte retrieval rate in suboptimal responders.

Eligibility criteria:
inclusion criteria: • patients are less than 38 years old * patients have primary or secondary infertility * patient is candidate for icsi * normal antral follicles count * amh more than 1 exclusion criteria: * age more than 38 years old * patients have other options for assisted reproductive techniques like * intrauterine insemination. * severe male factor * amh less than 1 * recurrent icsi failure

Keywords: icsi dual trigger
study to evaluate the safety and efficacy of adalimumab in mps i, ii, and vi

Conditions: Mucopolysaccharidosis I; Mucopolysaccharidosis II; Mucopolysaccharidosis VI

Summary: randomized, double-blind, placebo-controlled, parallel-group, single-center study followed by open-label phase, to evaluate the effects of adalimumab compared to placebo on the change from baseline in joint and skeletal disease in children and adults with mucopolysaccharidosis (mps) i, ii or vi.

this study is a randomized, double-blind, placebo-controlled, parallel-group, single-center study followed by open-label phase, to evaluate the effects of adalimumab compared to placebo on the change from baseline in joint and skeletal disease in children and adults with mucopolysaccharidosis (mps) i, ii or vi. children and adults diagnosed with mps i, ii or vi, with significant joint restrictions and pain will be randomized to adalimumab treatment or placebo treatment for the first 16 weeks. this will be followed by a 32-week open label adalimumab treatment phase.

Eligibility criteria:
inclusion criteria: * male or female ≥5 years of age; * diagnosis of mps i, ii or vi; * treatment with ert for ≥1 year or no treatment with ert for ≥1 year; * weight ≥15 kg; * significant bodily pain reported by the chq-pf50 or sf-36 (\> 1 sd more severe \[below\] than the general population mean); * ≥ 3 joints with limitations in motion; and patient or parent/legal guardian is able and willing to provide informed consent. for patients 7 to 17 years of age, assent must also be provided. exclusion criteria: * history of hct less than 2 years prior to enrollment; * immune suppression therapy less than 1 year prior to enrollment; * active graft versus host disease; * current diagnosis or history of lymphoma or other malignancy; * current active infection; * history of serious opportunistic infection (e.g., bacterial \[legionella and listeria\]; tuberculosis \[tb\]; invasive fungal infections; or viral, parasitic, and other opportunistic infections); * positive tb skin test, positive quantiferon-tb gold tb test, positive chest x-ray, or a recent exposure to tb * congestive heart failure defined by an ejection fracture \<50% measured by echo; * demyelinating disorders (e.g., central nervous system \[cns\] disorders including multiple sclerosis and optic neuritis and peripheral nervous system disorders including guillain-barre syndrome); * hematologic abnormalities (e.g., pancytopenia, aplastic anemia); * hepatitis b infection (active or chronic carrier); * latex sensitivity; * pregnancy or breastfeeding; * known or suspected allergy to adalimumab or related products; * participation in simultaneous therapeutic study that involves an investigational study drug or agent within 4 weeks of study enrollment; * requirement for live vaccine exposure that would be expected to occur during the time frame of the study; or * any other social or medical condition that the investigator believes would pose a significant hazard to the subject if the investigational therapy were initiated or be detrimental to the study.
evaluation of efficacy of ophthalmic solution in induced acute allergic conjunctivitis

Conditions: Allergic Conjunctivitis

Summary: the purpose of this study is to establish the efficacy of r89674 0.25% ophthalmic solution compared with placebo in alleviating the signs and symptoms of conjunctival allergen challenge-induced allergic conjunctivitis


Eligibility criteria:
inclusion criteria: * history of ocular allergies and a positive skin test reaction to cat hair, * cat dander, grasses, ragweed, and/or trees within the past 24 months; * calculated best-corrected visual acuity of 0.6 logmar or better in each eye; - positive bilateral conjunctival allergy challenge reaction exclusion criteria: * narrow angle glaucoma, * clinically significant blepharitis, follicular conjunctivitis, iritis * pterygium or diagnosis of dry eye * ocular surgical intervention within 3 months * history of refractive surgery within 6 months * known history of retinal detachment, diabetic retinopathy, or progressive retinal disease * presence of active ocular infection positive history of an ocular herpetic infection * preauricular lymphadenopath manifest signs or symptoms of clinically active allergic conjunctivitis

Keywords: ocular, allergic conjunctivitis, ophthalmic
a study of nivolumab combined with ipilimumab and nivolumab alone in patients with advanced or metastatic solid tumors of high tumor mutational burden (tmb-h)

Conditions: Pan Tumor

Summary: the purpose of this study is to demonstrate the clinical activity of nivolumab in combination with ipilimumab in multiple types of tumors based on their tumor mutational burden status.


Eligibility criteria:
inclusion criteria: * participants with a refractory, metastatic, or unresectable histologically or cytologically confirmed solid malignant tumor with high tumor mutational burden (tmb-h) who are refractory to standard local therapies, or for which no standard treatment is available. * must be able to provide tissue and blood tmb-h testing results * must have measurable disease for response assessment exclusion criteria: * participants with melanoma, non-small cell lung cancer (nsclc), renal cell carcinoma (rcc) or hematological malignancy as primary site of disease * participants who received prior treatment with an anti-programmed death-1 (anti-pd-1), anti-programmed death ligand 1 (anti-pd-l1), anti-programmed death ligand 2 (anti-pd-l2), anti-cd137, or anti-cytotoxic t-lymphocyte-associated protein 4 (anti-ctla-4) antibody, or any other antibody or drug specifically targeting t-cell co-stimulation or checkpoint pathways * treatment with any chemotherapy, radiation therapy, biologics for cancer, or investigational therapy within 28 days of first administration of study treatment other protocol defined inclusion/exclusion criteria apply.

Keywords: tmb-h
prenatal probiotic intervention

Conditions: Childhood Obesity; Maternal Obesity During Childbirth; Insulin Resistance; Inflammation

Summary: this study will assess the feasibility of a randomized control trial in which the effects of probiotic supplementation throughout pregnancy on maternal insulin sensitivity and inflammation, as well offspring gene expression and body composition are examined.

maternal obesity leads to increased insulin resistance and inflammation which have been shown to induce fetal adaptations and greater risk of obesity in the offspring. probiotic supplementation during pregnancy has been shown to improve insulin sensitivity in normal weight women. however, little is known on the effects of probiotic supplementation throughout pregnancy on maternal insulin sensitivity and inflammation as well as offspring gene expression and body composition. long term nutritional supplementation, however, is associated with increased participant burden as well as lower compliance and retention rates. thus, this study will assess the feasibility of a long term probiotic supplementation study in obese pregnant women. acceptance and compliance with daily capsules throughout pregnancy and study procedures will be assessed.

Eligibility criteria:
inclusion criteria: * bmi ≥ 30 * ≥ 18 years of age * singleton pregnancy * less than 12 weeks of gestation * less than 1 serving of yoghurt with live cultures or cultured milk per week * conceived without assisted fertility treatments exclusion criteria: * • women with pre-existing medical conditions (e.g., diabetes, hypertension, thyroid disorders, heart disease or immune disorders) as determined by the pi to affect the outcomes of interest * immunosuppressed women * women taking medications during pregnancy known to affect fetal growth (i.e., thyroid hormone, glucocorticoids, insulin, oral hypoglycemic agents) * women who are using recreational drugs, tobacco or alcohol during their pregnancy * milk intolerance or allergy * consuming probiotic supplements

Keywords: obesity inflammation pregnancy programming
a study of second-line treatment with apatinib for advanced intrahepatic cholangiocarcinoma

Conditions: Intrahepatic Cholangiocarcinoma

Summary: the propose of this study is to confirm safety and efficacy of apatinib monotherapy in patients with advanced cholangiocarcinoma.


Eligibility criteria:
inclusion criteria: 1. ages 18-65 years; 2. eastern cooperative oncology group performance score (ecog): 0-2; 3. estimated survival time \> 3 months; 4. patients with recurrent or metastatic cholangiocarcinoma with histologic or cytological diagnosis; 5. previous first-line gp programmes failed, or were not able to withstand first-line treatment; 6. at least one measurable lesion \[spiral ct scan ≥ 10 mm (ct scan thickness not greater than 5mm)\], measurable lesions were not treated with radiotherapy or other topical treatments unless progress was achieved after treatment was completed (recist version 1.1); 7. adequate hepatic, renal, heart, and hematologic functions: anc ≥ 1.5×109/l, plt ≥ 75×109/l, hb ≥ 8 g/dl,alb ≥2.8g/dl，tbil ≤ 3×uln, alt or ast≤ 2.5×uln (or ≤ 5×uln in patients with liver metastases), cr clearance ≥ 50 ml/min;thyroid function is normal； 8. no serious history of drug allergy； 9. subjects volunteered for the study. sign informed consent, good compliance, with follow-up. exclusion criteria: 1. patients have received targeted therapy； 2. patients with contraindications (active bleeding, ulcers, intestinal perforation, intestinal obstruction, within 30 days after major surgery, uncontrolled high blood pressure medication, iii-iv level cardiac insufficiency, severe liver and kidney dysfunction)； 3. coagulation dysfunction (inr\> 1.5, pt\> uln +4s or aptt\> 1.5 uln), with bleeding tendency or ongoing thrombolysis or anti-blood coagulation treatment； 4. urine routine showed that urine protein ≥++ or the urine protein in 24 hours\>1.0 g； 5. pregnant or lactating women； 6. history of other malignancy within 5 years except for effectively treated skin basal cell carcinoma, cutaneous squamous cell carcinoma and / or effectively excised orthotopic cervical and / or breast cancer; 7. the researchers judged other conditions that might affect clinical research and the outcome of the study.
evaluating lanolin for the treatment of nipple pain among breastfeeding women

Conditions: Pain

Summary: the purpose of this study is to evaluate the effectiveness of lanolin for the treatment of painful/damaged nipples among breastfeeding women, and to evaluate if the use of lanolin has an effect on breastfeeding outcomes such as duration and exclusivity.


Eligibility criteria:
inclusion criteria: * maternal complaint of nipple pain with any sign of nipple trauma to one or both nipples, such as blistering, crusting, redness, bleeding, swelling, cracking, discoloration or peeling. * infant delivered at, or greater than 37 weeks gestation. * singleton birth. * speaks and understands english. * access to telephone. exclusion criteria: * infant not expected to be discharged home with mother. * infant with congenital abnormalities that would impair breastfeeding. * maternal allergy to lanolin. * maternal health conditions that may interfere with breastfeeding (physical or mental illness) as determined by hospital staff.

Keywords: nipple pain breastfeeding nipple damage lanolin clinical trial
perillyl alcohol in treating patients with metastatic breast cancer

Conditions: Breast Cancer

Summary: rationale: drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. purpose: phase ii trial to study the effectiveness of perillyl alcohol in treating patients with metastatic breast cancer that has not responded to previous chemotherapy.

objectives: i. determine the clinical effectiveness (i.e., objective tumor response, time to treatment failure, and survival) of perillyl alcohol in patients with previously treated metastatic breast cancer. ii. define the acute and chronic toxic effects of perillyl alcohol in this patient population. outline: patients are given oral perillyl alcohol 4 times per day. dose escalation of perillyl alcohol may occur in individual patients if no unacceptable toxicity is observed. treatment is continued as long as the patient benefits from treatment, does not show progressive disease, and does not experience irreversible or life threatening toxicity. patients are evaluated for response monthly while receiving treatment on this study. patients are followed at 2-4 weeks after the last treatment. projected accrual: approximately 40 patients will be accrued over 2 years.

Eligibility criteria:
disease characteristics: microscopically confirmed metastatic breast cancer must be refractory or have recurred after at least 1 systemic chemotherapy regimen estrogen receptor positive tumors must have failed or recurred after hormonal therapy at least 1 site of measurable disease required previously radiated lesions are not considered measurable unless there is evidence of disease progression after completion of radiation therapy no known brain metastases hormone receptor status: unspecified patient characteristics: age: 18 and over menopausal status: not specified performance status: zubrod 0-2 life expectancy: at least 12 weeks hematopoietic: wbc at least 4000/mm3 platelet count at least 100,000/mm3 absolute neutrophil count at least 1500/mm3 hepatic: bilirubin no greater than 1.5 mg/dl sgot no greater than 2 times normal renal: creatinine no greater than 1.5 mg/dl bun no greater than 30 mg/dl other: effective birth control must be used by fertile patients (barrier method preferred) not pregnant or nursing prior concurrent therapy: recovered from toxic effects of prior treatment biologic therapy: no immunologic therapy within the past 2 weeks chemotherapy: no chemotherapy within the past 4 weeks (6 weeks for mitomycin or nitrosoureas) see disease characteristics endocrine therapy: no hormonal therapy within the past 2 weeks see disease characteristics radiotherapy: no radiotherapy within the past 4 weeks see disease characteristics surgery: not specified other: no concurrent cholesterol lowering agents, supplemental vitamins, or other antioxidants

Keywords: stage iv breast cancer recurrent breast cancer
regional anesthesia for thoracoscopic surgery

Conditions: Postoperative Pain

Summary: aim of the study is to evaluate different regional anesthesia regimes for thoracoscopic surgery to evaluate their efficiency in (postoperative) pain control. three regional anesthesia forms are evaluated: thoracic epidural anesthesia, (ultrasound-guided) serratus-anterior-plane-block an local infiltration with local anesthetic at the site of performing the thoracoscopy.

a prospective evaluation of different regional anesthesia regimes for thoracoscopic surgery to elucidate their efficiency in (postoperative) pain control. a day before surgery the patients gave their written informed consent to the study. patients choose their favorite regional anesthesia out of the following: thoracic epidural anesthesia, (ultrasound-guided) serratus-anterior-plane-block an local infiltration with local anesthetic at the site of performing the thoracoscopy. in addition a general anesthesia was applied for the surgical procedure. anesthesia was maintained using propofol and remifentanil. the patients pain score (visual analog scale), consumption of analgesic medication, satisfaction with pain therapy will be obtained one, six, 24 and 48 hours postoperatively. these prospective evaluation of different regional anesthetic techniques might provide us data to recommend a procedure for thoracoscopic surgery.

Eligibility criteria:
inclusion criteria: * patients scheduled for thoracoscopic surgery * asa 1-3 exclusion criteria: * asa 4 and 5 * age under 18 and over 80
nursing care of bipolar patients with sleeping disorders using luminotherapy and /or psychoeducation program (biplumino)

Conditions: Bipolar Disorder

Summary: bipolar disorder affects more than 1% of the population. this pathology is considered as one of the most serious psychiatric disorder because of it is high suicide rates. it impacts patients life quality on many aspects, and specially their sleeping and circadian rhythms. this can lead to more severe symptoms up to for thymic relapses. it was shown that luminotherapy and psychoeducation program have a positive impact on these type of symptoms.


Eligibility criteria:
main inclusion criteria: * bipolar disorder (type 1 and 2 according to dsm v) * mood disorder questionnaire mdq ˂ 7 * sleeping and circadian rhythms disorders * under treatment main exclusion criteria: * no addiction except for tobacco * narcolepsy * sleep apnea * psychiatric comorbidities * suicidal ideation
obstetric life support, a curriculum to effectively resuscitate pregnant patients experiencing cardiac arrest.

Conditions: Cardiac Arrest; Pregnancy Related

Summary: the objective of the study is to determine if obstetric life support program (obls) has an effect on the confidence and skills knowledge in participants.

enrolled participants with healthcare experience will be randomized to intervention with an electronic curriculum and instructor-led course or placebo first and then will be crossed over to receive the intervention. participants will undergo assessments pre and post intervention, as well as repeat assessments after three washout periods separated by six months each.

Eligibility criteria:
inclusion criteria: ph 1. all genders 2. ems healthcare providers of all levels including basic, advanced, paramedics; firefighters, law enforcement officers, and trainees in any of these programs. 3. 18 years old or older 4. ability to read, write and speak in english ih 1. all genders 2. emergency medicine providers (ed, fp, icu) surgeons (ob), anesthesiologists, trainees of gme, and nurses from ed, fp, icu/nicu, or ob/l\&d. 3. 18 years or older 4. ability to read, write and speak in english exclusion criteria: 1. participants included in the pilot-testing sessions 2. participants from other medical specialties not listed in the inclusion criteria.

Keywords: the obstetric life support program (obls)
buprenorphine dose alteration study - 1

Conditions: Opioid-Related Disorders

Summary: the purpose of this study is to examine the effects in buprenorphine dose alterations in opioid dependent individuals being maintained on buprenorphine.


Eligibility criteria:
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